脊髓损伤的康复

Rehabilitation of spinal cord injuries.

作者信息

Nas Kemal, Yazmalar Levent, Şah Volkan, Aydın Abdulkadir, Öneş Kadriye

机构信息

Kemal Nas, Department of Physical Medicine and Rehabilitation, School of Medicine, Sakarya University, Korucuk, Sakarya, 54290 Turkey.

出版信息

World J Orthop. 2015 Jan 18;6(1):8-16. doi: 10.5312/wjo.v6.i1.8.

Abstract

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary.

摘要

脊髓损伤(SCI)是指从枕骨大孔至马尾神经的脊髓损伤,其由压迫、切割或挫伤引起。世界上脊髓损伤最常见的原因是交通事故、枪伤、刀伤、跌倒和运动损伤。功能状态与损伤是否完全以及损伤平面之间存在密切关系。脊髓损伤的结果不仅会损害独立性和身体功能,还包括损伤引发的许多并发症。神经源性膀胱和肠道功能障碍、尿路感染、压疮、体位性低血压、骨折、深静脉血栓形成、痉挛、自主神经反射异常、肺部和心血管问题以及抑郁障碍是脊髓损伤后常见的并发症。脊髓损伤会导致患者严重残疾,进而失去工作能力,带来心理社会和经济问题。脊髓损伤的治疗和康复期漫长、费用高昂且令人疲惫。无论损伤是完全性还是不完全性,脊髓损伤康复都是一个漫长的过程,需要患者及其亲属的耐心和积极性。早期康复对于预防关节挛缩和肌肉力量丧失、维持骨密度以及确保呼吸和消化系统的正常功能至关重要。与其他类型的康复一样,跨学科方法在脊髓损伤康复中至关重要。该团队由一名物理治疗师领导,必要时还包括患者家属、物理治疗师、职业治疗师、营养师、心理学家、言语治疗师、社会工作者和其他顾问专家。

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